Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
PR Vaccine Pneumococcal Conjugate 20 Valent (Pcv20) Im
Low
$144
Average
$512
Median
$469
High
$1.5k
Each hospital's average Premera rate, under the methodology and billing class chosen below.
62 hospitals; the 90th percentile is 2.6× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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94 hospital rates
iThe hospitals that file a Premera rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · both | 1 | $609 | $609 | — | — | 40 | $609 – $609 |
| 2 | Public Hospital Dis No 1 Skagit dba Skagit Valley Hospital Vernon, WA fee schedule · outpatient | 1 | $609 | $609 | — | — | 40 | $609 – $609 |
| 3 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · outpatient | 1 | $313 | $313 | — | — | 26–35 | $313 – $313 |
| 4 | Mercy Health Saint Marys Rockford, MI professional · fee schedule · outpatient | 1 | $299 | $299 | — | — | 26–35 | $299 – $299 |
| 5 | Seattle Children's Hospital Seattle, WA facility · percent of total billed charges · bothfrom % of charges | 5 | $426 | $416 | $70 | 17% | 11 | $338 – $519 |
| 6 | Mishawaka Medical Center Mishawaka, IN professional · fee schedule · both | 1 | $310 | $310 | — | — | 2–20 | $310 – $310 |
| 7 | Mount Carmel East Reynoldsburg, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $596 | $596 | — | — | 2–20 | $596 – $596 |
| 8 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 1 | $299 | $299 | — | — | 2–20 | $299 – $299 |
| 9 | St Peters Hospital Albany, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $400 | $400 | — | — | 2–20 | $400 – $400 |
| 10 | Central Washington Health Services Association Wenatchee, WA percent of total billed charges · bothfrom % of charges | 4 | $825 | $754 | $180 | 24% | 1–10 | $285 – $850 |
| 11 | Mercy Health Hackley Campus Muskogen, MI professional · fee schedule · outpatient | 1 | $299 | $299 | — | — | 1–10 | $299 – $299 |
| 12 | Mount Carmel St Ann's Lewis Center, OH professional · percent of total billed charges · bothfrom % of charges | 1 | $596 | $596 | — | — | 1–10 | $596 – $596 |
| 13 | Samaritan Hospital Troy, NY professional · percent of total billed charges · outpatientfrom % of charges | 1 | $400 | $400 | — | — | 1–10 | $400 – $400 |
| 14 | Virginia Mason Medical Center Seattle, WA facility · percent of total billed charges · outpatientfrom % of charges | 2 | $364 | $278 | $164 | 59% | 1–10 | $14 – $441 |
| 15 | Catholic Health Initiatives-Iowa Corp Des Moines, IA facility · fee schedule · both | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 16 | Catholic Health Initiatives-Iowa Corp Des Moines, IA professional · fee schedule · inpatient | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 17 | Catholic Health Initiatives-Iowa Corp West Des Moines, IA facility · fee schedule · both | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 18 | Central Community Hospital Elkader, IA facility · fee schedule · both | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 19 | Central Community Hospital Elkader, IA professional · fee schedule · inpatient | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 20 | Central Community Hospital Elkader, IA professional · fee schedule · outpatient | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 21 | Columbia Lutheran Charities Astoria, OR facility · percent of total billed charges · bothfrom % of charges | 1 | $656 | $656 | $423 | 64% | — | $234 – $1.1k |
| 22 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · both | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 23 | Covenant Medical Center Inc Waterloo, IA facility · fee schedule · outpatient | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 24 | Covenant Medical Center Inc Waterloo, IA professional · fee schedule · both | 1 | $313 | $313 | — | — | — | $313 – $313 |
| 25 | Diley Ridge Medical Center Canal Winchester, OH facility · fee schedule · both | 1 | $469 | $469 | — | — | — | $469 – $469 |
← Payers reporting CPT 90677 · Snapshot 20261111T120946Z-9134e7f7